HomeMy WebLinkAboutPlumbing 03-0667
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
~-), ;1
ADDRESS
(o.oq 4
,v11f1Y/.r V'.-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
3 -G to 1
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
If.2-d ~!-t-
~~
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~-~ ----
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: 1M ~- "23-0 &'ner/Contr:
CALL 447~O FOR THE NEXT INSPECT/ON 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
norblotNl 61(u~h;;on
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Date Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I. Blue File
2. Gold City
3. Yellow Applicant
PERMIT NO'03- ft,011
(Please type or print and sign at bottom)
ADDRESS
~09 L- N\0Jr\eN\ Gyc.1~ ~.~.
ZONING (offieeuse)
-el
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDdS- /~'/-OO~-jD
(1S-Z) 1l/0" 353~
~~~R Hu.'obiAAd) Kobut
(Address) t009 4- MAK~ eN-. S.E,
APPLICANT... \ Ll ~l L
(Name) \'->0\0 OW\ , WW\r.),,^~
(Address) 210 S- &,J,'€,IJ Ifv e . ~
(Address)
(Phone)
(Phone)
Me Is
(City)
(f.p\7-'1 827 ~"033
-fSt/o~
(Zip Code)
(Contact Person)
(Phone)
~PLlCANTSIGNATURE ~~~ DATE
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
5/23/tJ3
Quantity
Type of Fixture
'K
Rough-ins
Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50
Residential, Additions & Alterations $39.50
Estimated Cost $
Building Permit #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
51-SV
.50
Lfb.oo
(Office Use Only)
,~
This Application Becomes Your Building Permit When Approved
Building Official
Date
Paitti L/tJ,.....--'
Date&, --1--()3
I ReceiP}/i/5b~
IBY~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Ave., S.E., Prior Lake, MN 55372-1714